内固定加皮瓣转移治疗胫骨平台粉碎性骨折并胫前皮肤缺损

Surgical Treatment of Comminuted Fracture of Tibia Plateau with Skin Defect by Non-transarticular Internal Fixation and Skin Flap

目的 探讨胫骨平台粉碎性骨折外伤性局部皮肤缺损的修复与非跨关节的内固定治疗的可行性。方法 对12例胫骨平台粉碎性骨折胫前皮肤损伤严重或缺损者应用同侧顺行舌形深筋膜转位皮瓣,并应用钢板螺钉行非跨关节的胫骨平台骨折复位植骨内固定和治疗。结果 6例行一期同侧顺行舌形转位皮瓣加AO“L”型、AO“T”型钢板内固定修复;另6例行二期同侧顺行舌形转位皮瓣加AO钢板内固定修复术,其中1例内固定并且加AO“L”型外固定架外固定混合治疗,12例均获得满意疗效。结论 对于胫骨平台粉碎性骨折伴有局部皮肤损伤严重者,采用非跨关节的内固定加皮瓣治疗可取得满意疗效。

Objective To investigate the feasibility of non-transatticular internal fixation combined with skin defect in the treatment of comminuted tibia plateau fracture with skin defect. Methods Twelve cases of comminuted tibia plateau fracture with skin deficit. We made use of deep fascicular antegrade transposition tongue-like flap in order to apply the non-transarticular internal plate and the screw fixation as well as bone implant. Results Six cases undergoing first phase antegrade tongue-like transposition flap with AO type L and type T plate internal fixation. Another 6 cases undergoing the same surgery but in the second phase. Two cases were with AO golf-bar-shape plate, 1 case with AO L-type external fixator. All 12 cases showed satisfactory results. Conclusion A better treatment of comminuted fracture of tibia plateau with skin defect is to combine non-transarticular internal fixation and skin flap.